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Introduction

Mashups in medicine seem to have become less important in recent years, especially in the period 2012 to 2014. While fewer traditional mashups have been created recently there is still room for health librarians to work with and mash digital information and data should they wish to do so. The next step for medical mashups is probably in the areas of syndromic surveillance, locative media (GIS), data curation and open data. For some insight into mashups in the medical field, see this [title PubMed search on mashups]. Note the diversity of applications in mashups especially decision support.

Within the last decade, various consumer devices have captured a range of health and well-being data, but no composite application has brought them together. By analyzing possible correlations or deviations in data across contexts, health librarians can reveal insights in health care, and help clinicians better understand their patients. In terms of their origins, mashups were linked to the headiest days of web 2.0 in that they brought together disparate websites and bits of information to create new, third tools. These tools also encouraged social interaction and collaboration. In bioinformatics, the idea of integrating data with sources of information (in essence, creating biomedical mashups) is of particular importance because it can save time. Rather than searching all relevant sites sequentially, biological entities can be searched together in one metasearch.

What are mashups?

Mashups are hybrid tools taking the functionality of two information sources, merging aspects of each, and creating something new. The popularity of mash-ups was first seen as a result of a 2005 Business Week article. An example of a useful and popular mashup is Google maps, which takes Google Earth and merges it with telephone directory information. Mashups share in the notion of open, participative and collaborative content building of the open access and open source movements. Mashup technology dates back to the web's earliest days. By using publicly-available, open-source code, mashups were used to create current awareness tools, using RSS feeds and JavaScript, and new search tools that combine both textual and visual elements. While mashups have always been experimental, they are deemed even moreso by health librarians in 2012. Still, where a mashup might provide a useful service to aid health librarians in their work, there is always room to explore creative methods of information delivery; therefore, each mashup should be evaluated on a case by case basis as to its suitability.

Mashups in medicine

Even though the number and quality of mashups has diminished since the 2009 Mashup Awards), notable mashups in health and medicine are still being created. Existing medical mashups utilize the Google maps api because of the visual aspect of web navigation. With only a handful of mashups to choose from, the following examples are meant to offer health librarians some examples and insight into the state of mashup technology circa 2013.

This government site points to mashups that connect people living with HIV and AIDS to services such as housing and meals, and assistance in finding HIV-related job openings. It also helps to locate AIDS candlelight memorials.

The award-winning, animated Avian flu mashup that tracks the spread of the H5N1 (bird flu) virus worldwide at Nature with the help of the Google maps api. Follow the news of avian flu outbreaks around the world, and attempts by scientists, public health experts, policy makers, and governments to control its spread.

eTBLAST is a text-similarity tool which extracts keywords from queries and weights them to identify a unique subset of the medical literature. A quantitative score is computed based on the above, which is a measure of similarity among the documents searched. eTBLAST outputs a list and ranks items by a similarity score. End users interact with this data as they do using dates, authors or journal name sorting methods in PubMed. The similarity-ranked lists help to compile lists to identify the most frequent and prominent authors in a given domain and the most frequent journals as targets for submission of publication rates over a period of time.

HEALTHMap brings different data sources together to achieve a unified and comprehensive view of the current global state of infectious diseases, and their effects on human and animal health. It also combines the Google maps api, RSS feeds from different news sources, and Google News, ProMED, the World Health Organization and Euro Surveillance. Through an automated text processing system, the data is aggregated by disease and displayed by location for user-friendly access to the original alert. HEALTHMap may be invaluable for health professionals and librarians who want to stay up-to-the minute with information on global health news.

MappyHealth.com is an application to assist in public health surveillance activities using Twitter. It can help track disease trends, and show where diseases are emerging or decreasing. The trending and filtering is done by a series of algorithms and map-reduce jobs. It is then presented in a variety of visual ways. As of now the service is in areas that speak English but will be expanded upon in the near future. The app may be used on your PC, tablet or phone.

TriageMe provides the tools to find health care to save everyone, hospitals and patients, money and time. Patients receive an SMS from triage.me post-emergency room discharge. By sending a text to triage.me with their problem and current address, the person is routed towards the nearest clinic, providing address and link to directions (for smartphone users).

Vimo was the first healthcare product and services mashup, or integrated comparison-shopping portal. Released in 2006, it allows businesses and consumers to research, rate and purchase health insurance and Health Savings Accounts (HSAs). It selects physician profiles from across the US and brings private-public data sources together for health consumers. It allows users to post reviews about health services and products. By using Google map's application interface (API), Vimo searches for the exact location of a health professional when users click names on a Google map.

Who Is Sick was started in 2006 with a mission to provide current and local sickness information (an epidemiological mashup) in the Los Angeles area of the U.S. With the belief in the power of people and faith that user-generated content is valuable, this mashup links sickness "data" with maps of the region. Given the slow adoption of web 2.0 technologies by the healthcare industry, Who Is Sick is meant to be a simple, user-friendly prototype for health consumers who wish to see disease outbreaks geographically as they are occurring.

iSpecies - life sciences mashup

In the area of biology and zoology, iSpecies applies the notion of mash-up to the life sciences, as Declan Butler says in Nature. iSpecies is part of a growing movement where interfaces merge tools such as Google’s maps and scientific information, such as GenBank and UniProt. iSpecies already boasts an array of species, searchable by scientific or common name. A search in iSpecies retrieves sequence data from NCBI, images from Yahoo and articles from Google scholar. It uses Touchgraph developed by HubMed and presents related articles as a spider diagram. Its developer authors iSpecies blog, and argues for further use of tags for images and metadata trawling, widening image search and ranking search results from different tools according to user criteria. If barriers to accessing data are lifted and data can be placed in public databases, information can be accessed directly by search functions underpinning mashups. For example, Yahoo.ca is open to Google maps api data, which was initially blocked; Amazon now provides access to their data for those who want to experiment with mashups. More mashups in medicine are possible with open source tools and data, something health librarians can promote from their individual libraries and blogs.

Health libraries and full participation in Web 2.0

Many different types of health libraries face a number of challenges in order to fully participate in the creation of information sources in web 2.0. One is finding the time to learn about web 2.0 while keeping up to quickly-advancing search technologies and publishing trends. That said, whether health librarians can adopt new technologies in order to move hospital and health libraries into the future - and strengthen relationships with users - is an important question open to debate. Clearly, some of these technologies will not, over the long term, survive. Some librarians have argued that hospitals discourage and prohibit web 2.0 tools from being used on their computer networks. Because host institutions have control over new web technologies, due to protection of data for privacy issues, medical libraries are often limited in their adoption and use of new software. Hospital firewalls block multimedia, and do not permit their use on library computers; thus, there are a number of libraries that cannot create their own intranet (or internet) library web pages. Because librarians are sometimes required to use an institutional content management system that prevents users from viewing and editing, some assert that hospital librarians feel their institution actively prevents technological progress in the interest of data security.

Canadian & international contexts

There is considerable potential to use mashup technology to create unique, Canadian sources of health information. At the moment, there does not seem to be either an academic doing experimental work in this area, or a health librarian doing research on mashups.

Mashup editors

Mashup platforms help users create mashups. Here are some examples:

Feed2JS <http://feed2js.org/> helps to position an RSS Mashup on a library website with added facility for customization. Enhancing information services in this way can save researchers valuable time and promote the library.